A client has been taking tricyclic antidepressants for many years for the treatment of depression. The client has developed SIADH and has been admitted to the acute care facility. What should the nurse carefully monitor when caring for this client? (Select all that apply)

Neurologic function

Strict intake and output

Liver function tests

Signs of dehydration

Urine and blood chemistry

Answer and Explanation

Correct Answer : A,B,E

Reasoning:

Choice A reason: Neurologic function must be monitored in SIADH, as excessive water retention causes hyponatremia, which can lead to cerebral edema, seizures, or altered mental status. Tricyclic antidepressants may exacerbate SIADH by stimulating ADH release, making neurologic assessment critical to detect complications like confusion or seizures early.

Choice B reason: Strict intake and output monitoring is essential in SIADH to manage fluid overload. Excessive ADH causes water retention, and tracking fluid balance helps guide fluid restriction therapy to correct hyponatremia. This ensures the nurse can assess the effectiveness of interventions and prevent worsening fluid accumulation.

Choice C reason: Liver function tests are not directly relevant to SIADH management. While tricyclic antidepressants can affect liver function, SIADH primarily involves water retention and hyponatremia, not hepatic issues. Monitoring liver function is more relevant for drug toxicity, not the fluid and electrolyte imbalances of SIADH.

Choice D reason: Signs of dehydration are not a concern in SIADH, which causes water retention and fluid overload. Dehydration is more typical of diabetes insipidus, where water loss occurs. In SIADH, the focus is on preventing excessive fluid accumulation, making dehydration monitoring unnecessary in this context.

Choice E reason: Urine and blood chemistry, including sodium and osmolality, are critical in SIADH to monitor hyponatremia and fluid status. Elevated urine osmolality and low serum sodium indicate ongoing ADH excess. Regular monitoring guides fluid restriction and therapy to correct electrolyte imbalances and prevent complications like cerebral edema.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Risk for injury is the priority for a client with left-sided hemiparesis post-stroke. Weakness on one side impairs mobility and balance, increasing fall risk. Home environment assessment ensures removal of hazards like rugs or clutter, promoting safety and preventing injuries, critical for stroke recovery.

Choice B reason: Ineffective coping may occur post-stroke due to emotional or functional challenges, but it is not the primary focus during home environment assessment. Physical safety from falls due to hemiparesis is more immediate, as coping issues are addressed through counseling, not environmental modifications.

Choice C reason: Noncompliance with treatment may affect stroke recovery but is not directly addressed by home environment assessment. Ensuring a safe environment to prevent falls due to hemiparesis takes precedence, as physical safety is critical before addressing behavioral or adherence issues in discharge planning.

Choice D reason: Diarrhea is unrelated to hemiparesis or home environment assessment post-stroke. It may occur from medications or other causes but does not pose an immediate risk like falls. The focus is on preventing injuries due to mobility issues, not gastrointestinal symptoms, in this context.

A. Encouraging increased oral intake B. Infusing IV fluids rapidly as ordered C. Administering glucose-containing IV fluids as ordered D. Restricting fluids

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Encouraging increased oral intake is inappropriate for SIADH, as it exacerbates water retention caused by excessive ADH. This would worsen dilutional hyponatremia and fluid overload, potentially leading to severe complications like cerebral edema, making fluid restriction the preferred approach to manage this condition.

Choice B reason: Infusing IV fluids rapidly is contraindicated in SIADH, as it increases fluid overload. Excessive ADH already causes water retention, diluting serum sodium. Rapid IV fluid administration could worsen hyponatremia and lead to neurological complications, such as seizures, due to further dilution of electrolytes.

Choice C reason: Administering glucose-containing IV fluids is not appropriate for SIADH, as it adds to the fluid volume, worsening water retention and hyponatremia. Glucose fluids do not address the underlying ADH excess and may exacerbate dilutional effects, increasing the risk of cerebral edema or other complications.

Choice D reason: Restricting fluids is the appropriate intervention for SIADH, as excessive ADH causes water retention, leading to hyponatremia. Limiting fluid intake helps correct the dilutional effect, increasing serum sodium concentration and reducing the risk of complications like cerebral edema, aligning with the goal of restoring fluid balance.

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A client has been taking tricyclic antidepressants for many years for the treatment of depression. The client has developed SIADH and has been admitted to the acute care facility. What should the nurse carefully monitor when caring for this client? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is completing discharge teaching for the client who has left-sided hemiparesis following a stroke. When investigating the client’s home environment, the nurse should focus on which nursing diagnosis?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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A client with a history of diabetes insipidus seeks medical attention for an exacerbation of symptoms. Which laboratory finding indicates to the nurse that the client has been restricting fluids in an attempt to control the symptoms?

A client has been taking tricyclic antidepressants for many years for the treatment of depression. The client has developed SIADH and has been admitted to the acute care facility. What should the nurse carefully monitor when caring for this client? (Select all that apply)

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